title: Vitamin D supplementation in a healthy, middle-aged population: actual practices based on data from a French comprehensive regional health-care database.
abstract: OBJECTIVE
  The debate surrounding recommendations for vitamin D supplementation in middle-aged patients (that is, 20-60 years of age) with low serum concentrations of 25-hydroxyvitamin D (25(OH)D) is growing. Our aim was to describe practices regarding vitamin D supplementation in this age group, which are basically unknown.
  
  
  METHODS
  We performed an analysis using exhaustive reimbursement data from the individuals in Rhône-Alpes area, a French region regrouping more than 6 million of inhabitants. The data were collected from the French Insurance Health-care System. Patients who were 20-60 years of age, had no severe comorbidities, had a 25(OH)D assay between 1 December 2008 and 31 January 2009 were identified. Those who received a subsequent prescription for vitamin D were included in this analysis. We described patterns of vitamin D supplementation by frequency and daily dose.
  
  
  RESULTS
  The sample in this study included 1311 patients. The mean age was 47.7 years (s.d.: 9.5) and the median age was 50.2 years. Most of the participants (that is, 85.9%) were women. A total of 372 distinct prescription patterns for vitamin D supplementation were observed. The two most frequent (that is, 32.6% in total) involved a unique dispensation of a high dose of either 200,000 (17.5%) or 100,000 IU (15.1%). Most prescribed supplements were based on vitamin D3 (65%), and the most prescribed forms were high dose ampoules (81.6%). Only 48.9% of the participants were given a maintenance prescription after the initial loading phase.
  
  
  CONCLUSIONS
  Our results reveal a significant variability in the prescriptions for vitamin D supplementation from physicians in the French population. Moreover, less than half of the patients receive maintenance therapy after the initial loading phase of supplementation.
authors.affiliation: 1] Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Epidémiologie, Lyon, France [2] Inserm U INSERM 1033 Pavillon F, Service de Rhumatologie and de Pathologie Osseuse, Immunologie Clinique Cancérologie Osseuse, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Caillet
authors.forename: J C
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: S B
authors.initials: SB
authors.lastname: Jaglal
authors.forename: A
authors.initials: A
authors.lastname: Reymondier
authors.forename: E
authors.initials: E
authors.lastname: Van Ganse
authors.forename: R
authors.initials: R
authors.lastname: Chapurlat
authors.forename: A M
authors.initials: AM
authors.lastname: Schott
mesh_terms: D000328:Adult; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002762:Cholecalciferol / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D019587:Dietary Supplements; D005260:Female; D005602:France; D017408:Guidelines as Topic; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D055656:Prescriptions; D012016:Reference Values; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy*; D014815:Vitamins / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D